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#fibrin plug, how to manage

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A 77-year-old man presented with melena and pallor (Hb= 7gm/dl) was admitted to the endoscopy unit. The patient gives a history of child C liver cirrhosis. The patient underwent upper digestive endoscopy. The scope showed a fibrin plug with a surrounding reddish area on esophageal varices. Just before the banding of this fibrin plug, this plug began to ooze. Banding of the plug with 2 rubber bands was done. To be sure that the bleeding was stopped, the endoscopist checked the site of banding (video 3, also showed two variceal bands that partially obstruct the esophageal lumen) and it looked well.

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